title: HPV-related oropharyngeal squamous cell carcinomas: a comparison between three diagnostic approaches.
abstract: OBJECTIVE
  HPV-related oropharyngeal squamous cell carcinomas clearly represent a growing entity in the head and neck with distinct carcinogenesis, clinico-pathological presentation and survival profile. We aimed to compare the HPV prevalence rates and clinico-pathological correlations obtained with three distinct commonly used HPV detection methods.
  
  
  METHODS
  p16-immunohistochemistry (IHC), HPV DNA viral load by real-time PCR (qPCR), and HPV genotyping by a reverse hybridization-based line probe assay (INNO-LiPA) were performed on pretreatment formalin-fixed paraffin-embedded tumor samples from 46 patients treated for single primary oropharyngeal carcinomas.
  
  
  RESULTS
  Twenty-eight patients (61%) had a p16 overexpression in IHC. Twenty-nine patients (63%) harbored HPV DNA on qPCR. Thirty-four patients (74%) harbored HPV DNA on INNO-LiPA. The concordance analysis revealed a good agreement between both HPV DNA detection methods (κ=0.65); when both tests were positive, the depicted HPV subtypes were always concordant (HPV16 in 27 cases, HPV18 in 1 case). Agreement was moderate between IHC and qPCR (κ=0.59) and fair between IHC and INNO-LiPA (κ=0.22).
  
  
  CONCLUSIONS
  Certain highly sensitive methods are able to detect the mere presence of HPV without any carcinogenetic involvement while other more specific tests provide proof of viral transcriptional activity and thus evidence of clinically relevant infections. The use of a stepwise approach allows reducing false positives; p16-immunostaining seems to be an excellent screening test and in situ hybridization may overcome some of the PCR limitations.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Institut Gustave Roussy, 114 rue Edouard Vaillant, Villejuif, France.
authors.forename: Antoine E
authors.initials: AE
authors.lastname: Melkane
authors.forename: Haïtham
authors.initials: H
authors.lastname: Mirghani
authors.forename: Anne
authors.initials: A
authors.lastname: Aupérin
authors.forename: Patrick
authors.initials: P
authors.lastname: Saulnier
authors.forename: Ludovic
authors.initials: L
authors.lastname: Lacroix
authors.forename: Philippe
authors.initials: P
authors.lastname: Vielh
authors.forename: Odile
authors.initials: O
authors.lastname: Casiraghi
authors.forename: Franck
authors.initials: F
authors.lastname: Griscelli
authors.forename: Stéphane
authors.initials: S
authors.lastname: Temam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000302:isolation & purification; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D060005:Genotyping Techniques; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000821:virology*; D052162:Human papillomavirus 16; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization / Q000379:methods; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis* / Q000821:virology*; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D019562:Viral Load
chemical_list: D004279:DNA, Viral